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Parkinson Disease

The disease results in the central nervous system in the brain.  An English physician James Parkinson discovered it in 1817 for the first time. He described it as the “shaking palsy” since the tremor was the most prevalent symptom. The disease is characterized by intense tremors to extremities. Though there is no cure for Parkinson disease, there have been successful attempts to suppress the symptoms to a controllable level. With the technological advancements nowadays, a certain device has been improvised to ensure that the tremors witnessed are reduced by great amounts (Christensen, 2005).

Parkinson disease has many characteristics such as the slow, continuous tremors, muscle rigidity and having clamps. When this disease happens, degenerative changes are discovered in the neurons in the substantia nigra, with its location in the midbrain. The substantia nigra is a vital part that is involved in the coordination and control activities such as those of emotion and movement. It also controls several other functions of the body.

In case of minimal activity of the substantia nigra, this leads to less production of dopamine. Motor neurons are stimulated by dopemine while the nerve cells are purely responsible for the muscles control. In case of dopamine production depletion, the nerves of motor system are not in a position to take control over movement and enhance coordination. By the time the symptoms become visible, patients who suffer from Parkinson disease lose 80% or even bigger amount of their cells which produce dopemine. Parkinson disease is described by creation of smaller amounts of dopamine in the result of the elimination of these vital cells.

Parkinson disease symptoms can range from one individual to another. Signs at early stages may be delicate and may be unnoticed or ignored. These signs will become prevalent at the age of around 50. They manifest themselves slowly and gradually. Friends, family, the person who may possess it often do not notice them. It is imperative to visit a physician whenever one detects one of the symptoms. These symptoms will start on one side and will affect that side to the extremes even after it later comes to the other one. Parkinson disease symptoms range between tremors, muscle rigidity or shaking in the extremities, having communication troubles, difficulty while walking, having digestive and urinary problems (most commonly to do with constipation), and depression.

Two defining characteristics of Parkinson disease are bradykinesia and postural instability. Bradykinesia is basically a general reduction of spontaneous movement and flexibility, which in many cases brings about an element of abnormality due to the stillness posed and the way facial expressions are expressed. Postural instability is a tendency to be unstable when standing upright in an appropriate manner. A person affected with Parkinson disease has lost some of the reflexes that are needed for maintaining an upright stance, and they may topple backwards, if they are bumped slightly. Some of those with Parkinson disease may unintentionally sway backwards when standing up from a chair, standing or turning. Dementia may become evident and develop in up to one-third of people who have late-stage Parkinson disease. Dementia symptoms may range from disorientation at night, becoming confused, and having memory lapses. Medicines that are used to treat Parkinson disease can also contribute to this problem. The signs also differ with the age of the subject. Elderly people have been known to have signs such as hallucinations and confusion. Others will go into depression and can live for days without talking to anybody. Depression is very serious as research has shown it is the number one cause for suicide. The adjuncts to levopoda have also shown side effects such as nausea and dizziness. They are normally used for therapy but have not been very useful for this purpose.

Treatment at early stages helps  to slow down progression of Parkinson disease so a diagnosis at early stages is highly recommended. Parkinson disease early symptoms are often invisible, so it can be easily missed, mainly among young adults. A diagnosis of Parkinson disease is based on a person’s medical history and a neurological examination. As part of your medical history, your doctor will want to know about  any medications you take and whether you have a family history of neurological examination including an evaluation of Parkinson disease.  They emphasize on one’s ability to walk and coordinate as well as some simple hand to hand tasks. Parkinson disease can be detected in someone, if they show slowness and/or difficulty of movement. A doctor will usually ask the person to walk in a straight line and observe and look for any disturbances in their gait. Tremors in limbs when they are relaxed or symptoms appearing on the body from one side can also be an indication of Parkinson disease.

After these signs have been observed by a physician, the person may be put on a levodopa drug therapy.  If there is a powerful early response to this drug, it is then assumed that Parkinson may be afflicting the person. Magnetic resonance imaging (MRI), computerized tomography (CT) or positron-emission tomographic (PET) are used to exclude disorders with symptoms that are similar as progressive supranuclear palsy (Factor and Weiner, 2008). These tests are usually not needed when the symptoms described above are quite apparent and direct. Parkinson disease sometimes leads to surgery where the patient’s affected part of the brain may be cut, a process is referred to as ablative surgery. The main aim of destroying these parts or tissues is so that the production of those chemicals that are harmful and abnormal can be erased completely. This is a very simple process which is normally done when a patient is awake so as to ascertain whether the major symptom that is tremors go away. These are the chemicals that have been found out to be responsible for the production of the tremors that are common in patients with Parkinson disease. Another kind of surgery is the restorative surgery that is used to implant cells that will produce dopamine into the striatum. These cells will come from parts of the patient’s body.

At present there is no sure way to predict or prevent the Parkinson disease. It is widely known that Parkinson disease is a chronic and a progressive disease. Every person afflicted is different so the rate at which the disease progresses varies from one person to another. Every individual also experiences different symptoms, and varying degrees. This disease is not viewed as terminal but it is gradual and with time it becomes more and more fatal. During the late stages of Parkinson disease complications such as pneumonia, choking and falls may lead to the death of the affected person. 

The progression of symptoms in Parkinson disease may take more than 20 years. In some of the patients, however, the disease progresses in a pace that is faster. With proper treatment, most people with Parkinson disease can live a productive life of many years after diagnosis. In some current studies, it has been noted that mortality rate had increased rapidly. Hoehn and Yahr scale is one of the most commonly used system for describing how the symptoms of Parkinson disease progress. Another commonly used scale is the Unified Parkinson Disease Rating Scale also called the (UPDRS). This scale is much more complicated because it involves multiple ratings that measure motor and mental functioning, one’s behavior, mood, and the day-to-day activities. Hoehn and Yahr scale basically measures how the patients are coping with Parkinson disease and how the treatment is fairing. Neither of these scales is specific to Parkinson disease. Patients who have other ailments such as Alzheimer’s disease can also score in the Parkinson disease range.

Parkinson disease is one of the most popular neurodegenerative ailments after Alzheimer’s syndrome. The disease has been approximated to affect an estimated 6.3 million people worldwide, from all races, cultures and background. The reported spread of Parkinson disease changes extensively in international community-based studies; varying from 31 to 328 per 100,000 people. Parkinson disease is seen more as a person’s age progress. The disease also affects around 6% of young people according to the research carried out in the United States of America (Schwarz, 2008). The thing with this disease is that the symptoms develop gradually and one may delay in seeking medical evaluation. It has been suggested that the main reason the disease could affect the old age is because the production of dopamine is reduced due to the age-related fluctuations.

Certain risk factors such as age, genetics, gender and exposure to environmental toxins can increase your chances at acquiring Parkinson disease. The age at onset is usually over the age of 50 with more men acquiring Parkinson disease. In some cases, Parkinson disease occurs in families. A person of a tender age will be affected and as time goes on, siblings and children of the person gets the disease. It basically starts in the history of that family. Anyone can get Parkinson disease, but it is prevalent to the older generation. The disease can also be attributed to radiation, toxins and genetic backgrounds.

Other researches show that the disease affects both genders in equal measures. The disease shows neither geographic boundaries nor any ethnic discrimination. In the United States specifically, the numbers of the affected has risen from over one million people. New cases are cropping in day in day out. In the states, there are new ones amounting to well over 60 000 cases which is a worrying trend. Research has shown that the disease clearly manifests itself after the age of 65 but surprisingly a quarter of people have been diagnosed with Parkinson (Lieberman, 2002).

Drug Treatment and Therapy

The main objective of Parkinson disease treatment is to substitute the brain's supply of dopamine with a drug named Levodopa. Other drugs called dopamine agonists that can replicate dopamine effects on cells in the brain can be used too. Levodopa is an inactive pharmacological precursor, that is enzymatically converted to the neurotransmitter dopamine by neurons populations declining in the substantial nigra. Levodopa has proved to be a very effective kind of medicine since it can be used effectively to convert to dopamine. There is also this kind of medicine carbidopa that helps levodopa not to change outside the expected area that is the brain. This combination allows for the drug to work more effectively. It basically ensures that a great amount of it enters the brain and the desirable levels of dopamine enter the brain.

It also significantly reduces the side effects caused by increased levels of dopamine outside the brain by decreasing it outside the expected area that is the brain. If it happens outside the brain it would have adverse effects such as the blood pressure becoming low and profusely vomiting. Levodopa can be used to control symptoms of Parkinson disease at all stages of the disease. It ensures that the tremors experienced are decreased and the motor movement becomes well coordinated without any hitches. Levodopa is very effective in ensuring that the muscles become strong and well-coordinated so that the patient can lead an independent life without disturbing others (Weiner, 2007). The effects of the disability are decreased by great measures. Most people who take levodopa face problems especially when used in the long term. There are complications due to the therapy the patients are exposed to. Movement problems are the most common and troublesome complications.

Some researches prove that the patient may self-manage symptoms with the help of deep brain stimulation. During deep brain stimulation an electrode is implanted surgically in the internal globus pallidus, the subthalamic nucleus or ventral thalamus. One of the many therapies, that have proved to be very effective in the quest to reduce this threat posed by Parkinson disease, is physical therapy. It has been very effective in toning the muscles. It has also made them stronger therefore balancing becomes easier together with other motor activities. Patients with this condition are advised to engage in massage and yoga. This has greatly helped them to reduce rigidity which is prevalent among patients with Parkinson disease.

To date there is no cure for Parkinson disease. Current research has not come up with a mode in which the cells that are responsible for the production of dopamine can be replaced effectively. Most of these drugs portray side effects that cannot be taken lightly. There is one drug which releases dopamine. It is normally used at the initial stages of Parkinson disease to suppress its effects. Research has shown that this antiviral drug loses its effectiveness very fast. It also has side effects that are detrimental like the skin appears mooted. One may also become anxious and later his/her vision could be impaired. Anticholinergic drugs also have side effects such as constipation and having a dry mouth. They bring around urinary retention and if used in large amounts, may cause memory lapses. However, the drug has been very effective in ensuring that the overactivity taking place in the neurotransmitter is eradicated completely. This will control tremors that are evident in almost all Parkinson patients. Stalevo drug also has side effects but the advantage with this drug is that one can control them by modifying the schedule in which one takes the drugs. Nausea is one of the evident side effects of these drugs.

The main reason why we witness the degeneration of cells of the substantia nigra is not yet clear so paramedics have no choice but to ensure that the patient is treated for the symptoms rather than try to cure the disease. Studies conducted have shown that Parkinson disease may be caused either genetically or through an environmental toxin. One theory for explaining the problems connected with movement in Parkinson disease proposes an events chain involving the basal ganglia, brain stem, and cerebral cortex. 

The dopamine loss from the substantia nigra influenses the neuronal activity which is increased by the internal globus pallidus. Then, internal globus pallidus sends glutamate neurons to the brain stem and to the ventrolateral thalamus (Tuite et al., 2009). An accumulation of glutamate neurons in the ventrolateral thalamus and brain stem is seen by some researchers of the reason we see the motor dysfunctions in Parkinson. Currently there are 5 genes that scientists have discovered that are attributed to early, late or juvenile onset Parkinson disease. The PARK7 gene makes the DJ-1 protein, which may protect cells from oxidative stress. Mutations in the LRRK2 gene have been linked to late-onset Parkinson disease.

When Parkinson disease develops in a person, differences occur in part of the brain which are referred to as substantia nigra. This part is responsible for the production of dopamine. This chemical plays a big role in ensuring the motor capabilities function without a hitch. This disease has features such as lack of this important substance. The four cardinal symptoms of Parkinson disease are having frequent and unending tremors at the limbs and the arms, bradykinesia (slowness of movement), and postural instability, or impaired balance and coordination.

The only effective treatment of Parkinson disease is a drug called levodopa. It can reduce some of the symptoms of Parkinson disease but with prolonged use, certain side effects become apparent. There is currently no cure for Parkinson disease but current research in the field has led to many advances. Parkinson disease can be eased through activities that are not strenuous at all like swimming and merely taking a stroll. The importance of support groups to patients with this disease is imperative, since they give one hope and a sense of belonging. The need to actively engage in research to eliminate or reduce the risk posed by this threat is vital. Genetic engineering for example will require professional knowledge before it can be brought forward for the trials (Martin et al., 2010). Research is also vital as it is through it that new kinds of therapy can be improvised. It is important to ensure that as a patient, one always is in contact with a physician who will guide you on the kind of nutritional supplements that will aid into a comfortable life. There are some herbs that are very effective especially when used with prescribed dosages.

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